Provider Demographics
NPI:1558613182
Name:WALGREENS
Entity Type:Organization
Organization Name:WALGREENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:AMR
Authorized Official - Middle Name:
Authorized Official - Last Name:ABUALNADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-722-0741
Mailing Address - Street 1:2229 N MAIZE RD
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-7301
Mailing Address - Country:US
Mailing Address - Phone:316-722-0741
Mailing Address - Fax:
Practice Address - Street 1:2229 N MAIZE RD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-7301
Practice Address - Country:US
Practice Address - Phone:316-722-0741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-15458261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health